Crucial Skills®

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Crucial Conversations for Mastering Dialogue

Success Story: Crucial Conversations Training Improves Nurses' Ability to Address Disruptive Physician Behavior

Bad behavior runs rampant in the workplace. The healthcare industry is no exception. The American Medical Association’s Council on Ethical and Judicial Affairs defines disruptive behavior as behavior that “tends to cause distress among other staff and affect overall morale within the work environment, undermining productivity and possibly leading to high staff turnover or even resulting in ineffective or substandard care.”

Research among healthcare providers found widespread incidence of disruptive behaviors such as verbal abuse, sexual harassment, racial slurs, physical threats, and profanity. Specifically:

  • 91 percent of perioperative nurses reported at least one incident of verbal abuse in the previous year
  • 67 percent of staff nurses reported between one and five disruptive incidents in the previous month

One of the most common manifestations of bad behavior occurs between nurses and physicians in the form of power struggles and clashes over roles and personality. One study found that 95.7 percent of physician executives reported knowledge of disruptive physician behavior within their organization.

Not only is verbal abuse pervasive, it is also destructive. Research shows disruptive behavior leads to communication breakdowns that affect outcomes like patient safety and employee morale. Specifically, a study of twenty-six medical residents found that failures of communication between physicians and nurses were associated with 91 percent of the medical errors.

Verbal abuse also leads to medication errors which harm 1.5 million patients each year. A study by the Institute for Safe Medication Practices found that 93 percent of nurses and pharmacists experience condescending language and impatience from bully physicians when they ask clarifying questions about medical orders, and 87 percent encountered physicians who outright refused to answer their questions. As a result, 75 percent of nurses and pharmacists admitted to having a peer interpret a medication order rather than calling an intimidating physician.

Rebecca Saxton, PhD, RN, CNOR, and associate professor at the Research College of Nursing in Kansas City, Missouri, set out to uncover ways to reverse this divisive trend of abusive physician behavior and communication breakdowns. She collaborated with VitalSmarts to create an educational intervention tailored to the nursing experience that included the two-day Crucial Conversations Training course.

The Solution: Read our case study to learn how Rebecca used Crucial Conversations Training to improve perioperative nurses’ confidence and ability to address disruptive physician behavior.

You can learn more insights and skills like this in Crucial Conversations for Mastering Dialogue

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